Malaria case study Flashcards
Vector-borne
When a disease is biologically transmitted by a carrier
Number of people living in areas at risk
3.6 billion
Number of countries at risk
91
Distribution of countries at risk
Sub-Saharan Africa carries a disproportionately high share of the global deaths caused by malaria.
The region was home to 93% of malaria cases and 94% of malaria deaths.
Amount of deaths and cases in 2018 (according to the WHO)
228 million cases
405,000 deaths
Most vulnerable people
Children under 5
67% of all malaria deaths (272,000)
Prevalence in Africa
19 countries in Sub-Saharan Africa plus India carried almost 85% of the global malaria deaths.
6 main countries for malaria cases
Nigeria - 25%
Democratic Republic of Congo - 12%
Uganda - 5%
Cote d’Ivore (Ivory Coast) - 4%
Mozambique - 4%
Niger - 4%
Where do mosquitoes breed?
Stagnant water
When is the best time for transmission?
Just after the rainy season - in Africa the length of the malaria transmission season is directly related to the length of the rainy season.
Rain, altitude and Malaria
At altitudes above 1500m and where rainfall is below 1000mm, malaria transmissions fall.
Temperature and Malaria
High temperature is also important. The parasites require temperatures of between 16 degrees C and 32 degrees C to develop inside the mosquito and this is why the disease is largely concentrated in the tropics.
Symptoms of Malaria
- fever that comes and goes depending on the species of malaria
- initially feels like the flu: high fever, fatigue, body aches, hot and cold stages
- headache
-nausea - shaking chills (rigors)
- sweating
- weakness
Anaemia is common in patients with malaria, in part due to the effects of the plasmodium parasite on the red cells
Malaria in children
Signs and symptoms in children may be nonspecific, leading to delays in diagnosis.
Plasmodium falciparum
Causes a particularly severe form of malaria:
In addition to fever patients may experience complications such as
- destruction of red blood cells
- yellow skin discoloration
- kidney failure
- fluid in the lungs
- cerebral malaria
- convulsions
- coma
- death
Immunity
People who have lived for years in areas with malaria may develop a partial immunity to new infections.
Land use
Studies in India show that people living in close proximity to a forest are more susceptible to infection.
Housing quality
Homes with earth/sand floors using mud,bamboo or wooden trunks for walls and grass or palm leaves to provide a roof.
High density occupancy
Densely clustered built up areas and overcrowded rooms affect increasing risk.
Unsanitary conditions
Even though houses are usually clean surrounding areas that are dirty and polluted are associated with mosquitoes and increased risk.
Occupation
Agricultural workers are more exposed to mosquitoes.
Rural vs urban environments
Generally those in rural areas are seen to be at more risk. Urban contamination rates are high due to building density and unsanitary conditions.
Age and Gender
These are not significantly associated with risk of infection though children under 5 are more likely to suffer. In Gambia and Tanzania the burden is more from ages 5-14.
Income
strong positive correlation between income and the use of prevention methods. higher income is also associated with better nourishment.
Education
Those with a clear understanding of malaria and the risks are less likely to be at a greater risk.
Distance and accessibility
Greater distance to the nearest clinics or hospitals is associated with fewer seeking treatments for symptoms and less expenditure on prevention methods.
Disease of poverty
most of the variables are proxies for poverty and evidence suggests malaria is strongly associated with low socio-economic status.
Malaria killing kids
Malaria kills a child somewhere in the world every 2 mins.
Costs to individuals and families
travel to and treatments at clinics, purchase of drugs to treat malaria, lost income from absence at work.
Cost to government
building, staffing and maintaining healthcare facilities, purchase of drugs and of public health intervention.
Direct and indirect costs
Direct costs of malaria resulting from the provision of healthcare are thought to be around $15 - 18 billion each year globally.
Nets (ITN)
sleeping under a ITN is a particularly effective low cost barrier to mosquitoes.
Treatments
- anti malarial drugs
- vaccines
- mosquito coils
- indoor residual spraying
